Losing the bug battle

April 11, 2019

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GREED and stupidity are contributing to a potentially disastrous global health crisis. Beginning with penicillin, a family of antibiotic drugs was created capable a combating a wide range of conditions that would once have been deadly to the majority of those infected.

But the challenge has always been that bugs gradually build up resistance to antibiotics that were once able to check them. This is an inevitable and natural process. Medical scientists need to deploy different, often more powerful antibiotics. The urgent concern now is that the armory of different drugs, is almost exhausted. There are already bugs, such as Acinetobacter baumannii in Iraq, which cannot be knocked out by any antibiotic. Thus, surviving infection depends on the age and strength of the patient, the quality of care given and the ability of that patient’s own body to fight the infection by itself.

The medical profession always knew that the bacteria it fights would evolve in order to survive. This is the nature of every organism. But after the 1940s, when penicillin was being hailed as a wonder drug, the assumption of scientists was that they would always be able to keep ahead of the bugs.

The reason they have not has had a very great deal to do with greedy farmers and a significant number of foolish doctors and ignorant patients. The agricultural sector is always chasing greater profits. And one way to boost these is to dose animals with antibiotics. Such treatment is not only supposed to protect them from infections but also to bulk out their weight and thus sale price at the slaughterhouse. But it ought to have been glaringly obvious that by having antibiotics enter the food chain, there would be a long-term effect on people’s health because bacteria would be able to build up resistance to the drugs.

Then there are the lazy doctors who prescribe antibiotics as a matter of course, without thought for the eventual consequences. Worse there are the unthinking individuals who rush to the pharmacists and buy powerful antibiotics over the counter without prescription to treat conditions such as influenza or even the common cold. The horror is that these drugs are completely useless against such conditions. Moreover, all too often patients do not complete the recommended treatments, abandoning the course when they think they are better. The effect of anti-bacterial drugs is not instant but cumulative. An incomplete course makes it easier for bacteria to work up a resistance to the intervention that is supposed to kill them.

In Europe and North America the risks of unrestricted antibiotic use are now well appreciated, even if some doctors and agro-industries still stray on the danger side. Elsewhere, the appreciation of the hazards of this behavior remains limited. Unfortunately the Middle East and Asia are the main culprit regions.

The World Health Organization continues to warn the world is heading toward a “post-antibiotic” era where “common infections and minor injuries, which have been treatable for decades, can once again kill”. It warns that antibiotic resistance is putting all the achievements of modern medicine at risk. Organ transplants, chemotherapy and surgery become significantly more dangerous without effective antibiotics to prevent and treat infections.

The common assumption that scientific researchers will always come up with new remedies seems about to be proved tragically wrong.